Oncology Physiotherapy Management

Original Editor - Elaine Lonnemann

Top Contributors - Elaine Lonnemann and Evan Thomas

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Intervention Models

"Physical therapists are ideally situated to provide secondary preventive interventions and treatment, using prospective surveillance, to those surviving breast cancer."

  1. Breast Cancer–Related Lymphedema: Comparing Direct Costs of a Prospective Surveillance Model and a Traditional Model of Care by Nicole L. Stout, Lucinda A. Pfalzer, Barbara Springer, Ellen Levy, Charles L. McGarvey, Jerome V. Danoff, Lynn H. Gerber and Peter W. Soballe.Physical Therapy January 2012 vol. 92 no. 1 152-163
  2. Prospective Surveillance Model of Care provided by Physical Therapists incorporates examination of physical and functional domains into the medical model currently used for breast cancer care.
  3. Traditional Model of Care in Advanced-stage lymphedema by a specialized provider requires intensive decongestive therapy for adequate management.


Breast Cancer–Related Lymphedema: Comparing Direct Costs of a Prospective Surveillance Model and a Traditional Model of Care by Stout et. al.
Prospective Surveillance Model of Care
Traditional Model of Care in Advanced-stage Lymphedema
Preoperative examination: UE ROM, strength, limb volume, anthropometric measures (eg, body mass index), functional status, and level of physical activity
Complete decongestive therapy (CDT) requires daily, one-on-one skilled therapy with a specialized provider over the course of 4 to 6 weeks.
Education for a postoperative plan of care & how to monitor for signs and symptoms of early adverse effects of treatment such as pain, joint immobility, weakness, and lymphedema. Complex materials for limb volume decongestion, including short-stretch compression bandages, various types of padding, and other materials to bandage the limb.
Exercise for ROM and strength
Early identification, and intervention for lymphedema.
Ongoing clinical monitoring
Compression garments are applied daily --replaced at 6- to 9-month intervals to ensure effectiveness
Advice on returning to activities during and after treatment
Regular follow-up visits for routine surveillance are conducted at 3-month intervals postoperatively to repeat baseline tests and measures, identify changes indicative of impaired body structure and function, and provide ongoing education and monitoring for potential early and late adverse effects of treatment



Sensitivity analysis comparing varied incidence rates of lymphedema in the prospective surveillance model (PSM) and the traditional model (TM).

Link to view Graph

Key Evidence

Physical Therapy Intervention Following Surgical Treatment of Carpal Tunnel Syndrome in an Individual With a History of Postmastectomy Lymphedema by Julie E Donachy and Emily L Christian.  Physical Therapy 2002 Vol. 82 

Recent Related Research (from Pubmed)

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References


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